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Symposium on Hepatitis Care in Substance Users

PHAST is presenting a poster on community models to tackle the problem of Hepatitis C Virus which is a silent disease that can lead to serious conditions such as liver cancer.

Background
In England about 160,000 people are living with HCV. Acquisition through injection drug use accounts for about 90%. There is evidence of barriers to PWID treatment access into traditional hospital based HCV treatment models. New direct acting antivirals treatments (DAAs) provide community delivery opportunities to overcome these barriers. This review summarises current evidence regarding: barriers to HCV care and community integrated HCV treatment models for PWID in England.

Aim
To identify effective integrated HCV treatment models that successfully target at risk marginalised populations.
Key learning aims to stimulate discussion about how to optimise HCV care in marginalised populations and identify new research priorities.

Methods
This evidence synthesis included: a rapid literature review to identify studies relating to HCV care models including: the grey literature; a review of relevant case-studies of innovative ways to deliver HCV care and a series of semi-structured interviews with key stakeholders that included clinical, commissioning and academic experts. The findings were combined to determine the most effective treatment model strategies and intervention types. Key learning aims to stimulate discussion about how to optimise HCV care in marginalised populations.

Conclusions
This evidence synthesis identified that HCV is a major health problem that primarily affects disadvantaged groups and that current HCV pathways in England are largely failing to meet the needs of PWID. While there is general agreement regarding how to improve access barriers and good practice elements, there are few well evaluated published interventions. Alongside the focus on therapeutic innovation, if we want to achieve elimination of HCV as public health problem better research evidence on the cost-effectiveness of integrated community-based HCV treatment models must be prioritised. 596

Learning audience
This review found that

• HCV is a major health problem that primarily affects disadvantaged groups.

• Current HCV treatment pathways in the UK do not meet the needs of vulnerable populations

• Better research must be prioritised on the cost-effectiveness of integrated community-based HCV treatment models.